Leishmaniasis

Leishmaniasis of the nasal region, when seen in Mediterranean countries, is mostly in the form of an "oriental sore" caused by Leishmania tropica. In Central and South America it is mostly seen in the form of mucocutaneous leishmaniasis caused by Leishmania braziliensis [153, 197]. The protozoan parasite is seen in the cytoplasm of histiocytes or extracellularly, measures 1.5-3.0 p,m in its maximum dimension and has a nucleus and a rod-shaped kinetoplast that stains positively with Giemsa. The kinetoplast is more readily identified in Giemsa-stained smears of exudates or scrapings than in paraffin sections. The lesions, commonly found in the nasal mucosa and facial skin, are associated with chronic inflammatory reaction and granuloma formation. They are in general circumscribed and self-involutive in the case of the "oriental sore" and markedly destructive in mucocu-taneous leishmaniasis.

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